Diabetic Macular Edema

PALADIN subset finds improvement after 12 months with intravitreal implantAmong a subset of patients in the phase IV PALADIN study, there was improved visual acuity, improved macular thickness, and reduced treatment burden among patients treated with the intravitreal fluocinolone acetonide 0.2 µg (Iluvien implant) for DME.
Does dexamethasone implant add benefit in ranibizumab patients?The addition of dexamethasone implant (Ozurdex, Allergan) to a continuing regimen of ranibizumab (Lucentis, Genentech) did not produce results in visual acuity outcomes that differed from those achieved with ranibizumab alone at 6 months. However, there was an improvement in the central macular thickness on OCT in patients.
Aflibercept shows macular perfusion gains in VISTA subanalysisThe use of aflibercept led to greater improvement in macular perfusion status in a phase III trial with DME patients. Those with baseline nonperfusion tended to have more advanced disease.
These novel strategies may change DME treatment paradigmThere is subset of patients with resistant or persistent DME that forms the impetus for new treatment strategies, including next-generation anti-VEGF-A and new classes of drugs. Pravin U. Dugel, MD, outlines a list of potential treatment candidates that may lead that paradigm shift.
Treat-and-extend protocol reduces burden of anti-VEGF treatment for DMEResults of the prospective TREX-DME study provide an evidence base for using a treat-and-extend protocol for administering anti-VEGF injections for eyes with diabetic macular edema.
Suprachoroidal corticosteroid shows visual, anatomic improvements in DME eyesSuprachoroidal triamcinolone acetonide (CLS-TA, Clearside Biomedical) injection resulted in visual and anatomic improvements in eyes with diabetic macular edema, particularly in those that were treatment-naïve. Multiple injections of the investigational treatment were well-tolerated and associated with a low incidence of IOP elevation.
Phase IV study shows improved DME outcomes with fluocinolone acetonide implantThe fluocinolone acetonide 0.2 mcg/day implant (Iluvien, Alimera Sciences) offers an additional option for treating diabetic macular edema that reduces the need for subsequent therapy with anti-vascular endothelial growth factor or steroid treatment.
Nailing intravitreal implant injections
Nailing intravitreal implant injectionsTreating diabetic macular edema (DME) has evolved from the ETDRS-style focal/grid laser being the standard of care since 1985 to the modern era of pharmacotherapy—with anti-vascular endothelial growth factor (VEGF) injections now taking center stage as primary treatment for most patients.
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